scholarly journals Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study

10.2196/28589 ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e28589
Author(s):  
Sharon Orrange ◽  
Arpna Patel ◽  
Wendy Jean Mack ◽  
Julia Cassetta
Keyword(s):  
Patient Satisfaction ◽  
Los Angeles ◽  
Observational Study ◽  
Rank Order ◽  
Academic Medical Center ◽  
The United States ◽  
Retrospective Observational Study ◽  
Related Factors ◽  
Patients Satisfaction ◽  
Technical Issues

Background Los Angeles County is a hub for COVID-19 cases in the United States. Academic health centers rapidly deployed and leveraged telemedicine to permit uninterrupted care of patients. Telemedicine enjoys high patient satisfaction, yet little is known about the level of satisfaction during a crisis and to what extent patient- or visit-related factors and trust play when in-person visits are eliminated. Objective The aim of this study is to examine correlates of patients’ satisfaction with a telemedicine visit. Methods In this retrospective observational study conducted in our single-institution, urban, academic medical center in Los Angeles, internal medicine patients aged ≥18 years who completed a telemedicine visit between March 10th and April 17th, 2020, were invited for a survey (n=1624). Measures included patient demographics, degree of interpersonal trust in patient-physician relationships (using the Trust in Physician Scale), and visit-related concerns. Statistical analysis used descriptive statistics, Spearman rank-order correlation, and linear and ordinal logistic regression. Results Of 1624 telemedicine visits conducted during this period, 368 (22.7%) patients participated in the survey. Across the study, respondents were very satisfied (173/365, 47.4%) or satisfied (n=129, 35.3%) with their telemedicine visit. Higher physician trust was associated with higher patient satisfaction (Spearman correlation r=0.51, P<.001). Visit-related factors with statistically significant correlation with Trust in Physician score were technical issues with the telemedicine visit (r=–0.16), concerns about privacy (r=–0.19), concerns about cost (r=–0.23), satisfaction with telemedicine convenience (r=0.41), and amount of time spent (r=0.47; all P<.01). Visit-related factors associated with patients’ satisfaction included fewer technical issues (P<.001), less concern about privacy (P<.001) or cost (P=.02), and successful face-to-face video (P<.001). The only patient variable with a significant positive association was income and level of trust in physician (r=0.18, P<.001). Younger age was associated with higher satisfaction with the telemedicine visit (P=.005). Conclusions There have been calls for redesigning primary care after the COVID-19 pandemic and for the widespread adoption of telemedicine. Patients’ satisfaction with telemedicine during the COVID-19 pandemic is high. Their satisfaction is shaped by the degree of trust in physician and visit-related factors more so than patient factors. This has widespread implications for outpatient practices and further research into visit-related factors and the patient-provider connection over telemedicine is needed.

scholarly journals Patient Satisfaction and Trust in Telemedicine during the COVID-19 Pandemic (Preprint)

2021 ◽  
Author(s):  
Sharon Orrange ◽  
Arpna Patel ◽  
Wendy Jean Mack ◽  
Julia Cassetta
Keyword(s):  
Patient Satisfaction ◽  
Los Angeles ◽  
Rank Order ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Related Factors ◽  
Significant Positive Association ◽  
Patients Satisfaction ◽  
Technical Issues

BACKGROUND Los Angeles County is a hub for COVID-19 cases in the United States. Academic health centers rapidly deployed and leveraged telemedicine to permit uninterrupted care of patients. Telemedicine enjoys high patient satisfaction, yet little is known about the level of satisfaction during a crisis and to what extent patient or visit-related factors and trust play when in-person visits are eliminated. OBJECTIVE To examine correlates of patients’ satisfaction with a telemedicine visit. METHODS In this retrospective observational study conducted in our single-institution, urban, academic medical center in Los Angeles, internal medicine patients aged 18 years and above who completed a telemedicine visit between March 10th and April 17th, 2020 were invited for a survey (n=1624). Measures included patient-demographics, degree of interpersonal trust in patient-physician relationships using the” Trust in Physician Scale,” and visit-related concerns. Statistical analysis used descriptive statistics, Spearman rank-order correlation, and linear and ordinal logistic regression. RESULTS Of 1,624 telemedicine visits conducted during this period, 368 (22.7%) patients participated in the survey. Across the study, respondents were very satisfied (47.4%) or satisfied (35.3%) with their telemedicine visit. Higher physician trust was associated with higher patient satisfaction (Spearman correlation r=0.51, P<.001). Visit-related factors with significant correlation with trust in physician score were technical issues with the telemedicine visit (r=-0.16), concerns about privacy (r=-0.19), concerns about cost (r=-0.23), satisfaction with telemedicine convenience (r=0.41), and amount of time spent (r=0.47) (all P<0.01). Visit-related factors associated with patients’ satisfaction included fewer technical issues (P<.001), less concern about privacy (P<.001) or cost (P=0.02), and successful face to face video (P<.001). The only patient variable with a significant positive association was income and level of trust in physician (r=0.18, P<.001). Younger age was associated with higher satisfaction with the telemedicine visit (P=.005). CONCLUSIONS There have been calls for redesigning primary care after the COVID-19 pandemic and for the widespread adoption of telemedicine. Patients’ satisfaction with telemedicine during the COVID-19 pandemic is high. Their satisfaction is shaped by the degree of trust in physician and visit-related factors more so than patient factors. This has widespread implications for outpatient practices and further research into visit-related factors and the patient-provider connection over telemedicine is needed. CLINICALTRIAL IRB Approval University of Southern California July 2020 HS-20-00479

scholarly journals Patient Satisfaction and Trust in Telemedicine during the COVID-19 Pandemic   (Preprint)

2020 ◽  
Author(s):  
Sharon Elizabeth Orrange ◽  
Wendy Jean Mack ◽  
Julia Ann Cassetta ◽  
Arpna S Patel
Keyword(s):  
Patient Satisfaction ◽  
Los Angeles ◽  
Rank Order ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Urgent Care ◽  
Related Factors ◽  
Patients Satisfaction ◽  
Technical Issues

BACKGROUND Background: Los Angeles County is a hub for COVID-19 cases in the United States. Academic health centers rapidly deployed and leveraged telemedicine to permit uninterrupted care of patients. Telemedicine enjoys high patient satisfaction yet little is known about the level of satisfaction during a crisis and to what extent patient or visit-related factors and trust play when in-person visits are eliminated. OBJECTIVE Objective: To examine correlates of patients’ satisfaction with a telemedicine visit.  METHODS Methods: In this retrospective observational study conducted in our single-institution, urban, academic medical center in Los Angeles, we surveyed internal medicine patients who had completed a telemedicine visit between March 10th and April 17th, 2020 (n=1624). Measures included degree of interpersonal trust in patient-physician relationships using the ”Trust in Physician Scale”, visit-related concerns, and post-visit recovery. Statistical analysis used descriptive statistics, Spearman rank-order correlation, and linear and ordinal logistic regression.  RESULTS Results: Of 1,624 telemedicine visits conducted during this period, 368 (22.7%) patients participated in the survey. Across the study, respondents were very satisfied (47.4%) or satisfied (35.3%) with their telemedicine visit. Higher physician trust was associated with higher patient satisfaction (Spearman correlation r=0.51, P<.01). Visit-related factors with significant correlation with trust in physician score were report of telemedicine technical issues (r=-0.16), concerns about privacy (r=-0.19), concerns about cost (r=-0.23), satisfaction with telemedicine convenience (r=0.41), and amount of time spent (r=0.47) (all P<0.01).  Visit-related factors associated with patients’ satisfaction included fewer technical issues (P<0.01), less concern about privacy (P<0.01) or cost (P=0.02), and successful face to face video (P<0.01). The only patient variable with a significant positive association was income and level of trust in physician (r=0.18, P<.01). Younger age was associated with higher telemedicine satisfaction (P<0.01). Despite high satisfaction and degree of trust, most respondents required in-person evaluation after the telemedicine visit, and only 12 respondents (3.9%) recovered at home without additional telemedicine visits or in-person evaluation at urgent care or emergency room.  CONCLUSIONS Conclusions: Patients’ satisfaction with telemedicine during the COVID-19 pandemic is high. Their satisfaction is shaped by the degree of trust in physician and visit-related factors more so than patient factors. This has implications for outpatient practices and the widespread adoption of telemedicine and further research into visit-related factors and the patient-provider connection over telemedicine is needed.  CLINICALTRIAL IRB Approval 7/6/2020 Proposal #HS-20-00479

scholarly journals Real-world use of procalcitonin and other biomarkers among sepsis hospitalizations in the United States: A retrospective, observational study

PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0205924 ◽  
Author(s):  
Eric Gluck ◽  
H. Bryant Nguyen ◽  
Kishore Yalamanchili ◽  
Margaret McCusker ◽  
Jaya Madala ◽  
...  
Keyword(s):  
United States ◽  
Observational Study ◽  
Real World ◽  
The United States ◽  
Retrospective Observational Study

scholarly journals Evaluation of Patient Satisfaction with Tuberculosis Services in Southern Nigeria

2015 ◽  
Vol 8 ◽  
pp. HSI.S27177 ◽  
Author(s):  
Ugochukwu U. Onyeonoro ◽  
Joseph N. Chukwu ◽  
Charles C. Nwafor ◽  
Anthony O. Meka ◽  
Babatunde I. Omotowo ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Health System ◽  
Access To Care ◽  
Care Facility ◽  
Related Factors ◽  
Staff Attitude ◽  
Patients Satisfaction ◽  
Multilinear Regression Analysis ◽  
Southern Nigeria ◽  
Adherence Counseling

Objective Knowing tuberculosis (TB) patients’ satisfaction enables TB program managers to identify gaps in service delivery and institute measures to address them. This study is aimed at evaluating patients’ satisfaction with TB services in southern Nigeria. Materials and Methods A total of 378 patients accessing TB care were studied using a validated Patient Satisfaction (PS-38) questionnaire on various aspects of TB services. Factor analysis was used to identify eight factors related to TB patient satisfaction. Test of association was used to study the relation between patient satisfaction scores and patient and health facility characteristics, while multilinear regression analysis was used to identify predictors of patient satisfaction. Results Highest satisfaction was reported for adherence counseling and access to care. Patient characteristics were associated with overall satisfaction, registration, adherence counseling, access to care, amenities, and staff attitude, while health system factors were associated with staff attitude, amenities, and health education. Predictors of satisfaction with TB services included gender, educational status, if tested for HIV, distance, payment for TB services, and level and type of health-care facility. Conclusion Patient- and health system–related factors were found to influence patient satisfaction and, hence, should be taken into consideration in TB service programing.

scholarly journals A Chart Review of Substance Use Screening and Related Documentation among Adolescents in Outpatient Pediatric Clinics: Implications for Practice

2020 ◽  
Author(s):  
Lisa M. Kuhns ◽  
Brookley Rogers ◽  
Katie Greeley ◽  
Abigail L. Muldoon ◽  
Niranjan Karnik ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Logistic Regression ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Screening Tools ◽  
Multiple Logistic Regression ◽  
Related Factors ◽  
Standardized Screening

Abstract Background: Despite recent reductions, youth substance use continues to be a concern in the United States. Structured primary care substance use screening among adolescents is recommended, but not widely implemented. The purpose of this study was to describe the distribution and characteristics of adolescent substance use screening in outpatient clinics in a large academic medical center and assess related factors (i.e., patient age, race/ethnicity, gender, and insurance type) to inform and improve the quality of substance use screening in practice. Methods: We abstracted a random sample of 127 records of patients aged 12-17 and coded clinical notes (e.g., converted open-ended notes to discrete values) to describe screening cases and related characteristics (e.g., which substances screened, how screened). We then analyzed descriptive patterns within the data to calculate screening rates, characteristics of screening, and used multiple logistic regression to identify related factors. Results: Among 127 records, rates of screening by providers were 72% (each) for common substances (alcohol, marijuana, tobacco). The primary method of screening was use of clinical mnemonic cues rather than standardized screening tools. A total of 6% of patients reported substance use during screening. Older age and racial/ethnic minority status were associated with provider screening in multiple logistic regression models. Conclusions: Despite recommendations, low rates of structured screening in primary care persist. Failure to use a standardized screening tool may contribute to low screening rates and biased screening. These findings may be used to inform implementation of standardized and structured screening in the clinical environment.

scholarly journals Opioid prescribing patterns among medical providers in the United States, 2003-17: retrospective, observational study

BMJ ◽  
2020 ◽  
pp. l6968 ◽  
Author(s):  
Mathew V Kiang ◽  
Keith Humphreys ◽  
Mark R Cullen ◽  
Sanjay Basu
Keyword(s):  
United States ◽  
Observational Study ◽  
The United States ◽  
Prescribing Patterns ◽  
Retrospective Observational Study ◽  
Washington Dc ◽  
Medical Providers ◽  
Opioid Prescribing ◽  
One Year ◽  
Improving Patient Care

AbstractObjectiveTo examine the distribution and patterns of opioid prescribing in the United States.DesignRetrospective, observational study.SettingNational private insurer covering all 50 US states and Washington DC.ParticipantsAn annual average of 669 495 providers prescribing 8.9 million opioid prescriptions to 3.9 million patients from 2003 through 2017.Main outcome measuresStandardized doses of opioids in morphine milligram equivalents (MMEs) and number of opioid prescriptions.ResultsIn 2017, the top 1% of providers accounted for 49% of all opioid doses and 27% of all opioid prescriptions. In absolute terms, the top 1% of providers prescribed an average of 748 000 MMEs—nearly 1000 times more than the middle 1%. At least half of all providers in the top 1% in one year were also in the top 1% in adjacent years. More than two fifths of all prescriptions written by the top 1% of providers were for more than 50 MMEs a day and over four fifths were for longer than seven days. In contrast, prescriptions written by the bottom 99% of providers were below these thresholds, with 86% of prescriptions for less than 50 MMEs a day and 71% for fewer than seven days. Providers prescribing high amounts of opioids and patients receiving high amounts of opioids persisted over time, with over half of both appearing in adjacent years.ConclusionsMost prescriptions written by the majority of providers are under the recommended thresholds, suggesting that most US providers are careful in their prescribing. Interventions focusing on this group of providers are unlikely to effect beneficial change and could induce unnecessary burden. A large proportion of providers have established relationships with their patients over multiple years. Interventions to reduce inappropriate opioid prescribing should be focused on improving patient care, management of patients with complex pain, and reducing comorbidities rather than seeking to enforce a threshold for prescribing.

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